rt. side abdominal pain

[gt59]

I have been having lower rt. side abdominal pain for about 3 months now. The pain started very sharp shooting from about my rib to where my ovary would be.  Cat scan was ok. Colonoscopy was pretty ok 1 yr. ago. It gets really sore.  Lately pain has been strarting as a stomachache and then sharp and crampy feeling.  I also feel like there is a lump under my rt. rib. Last night it kept me up.

[J T Junig, MD PhD]

Thanks Jay-- That is a good point.   'Chronic pain' has become big draw for hospitals and clinics;  the people who care for chronic pain generally have a set of skills that are not related to the specific type of pain, but rather that are used to treat pain from any source.  For example, a person with chronic pain will need pain medications from various categories-- opiates, NSAIDS, anticonvulsants, muscle relaxants...  there will often be a psychologist in the clinic, and a physical therapist.... there may be a neurologist, a radiologist, and finally an anesthesiologist, for diagnostic and therapeutic procedures related to the source of the pain.

But before any of these people 'do their thing', the patient must see the appropriate medical specialists to make sure that there is nothing 'acute' that must be done.  If a person has abdominal adhesions, she doesn't need a chronic pain doc-- she needs a general surgeon.  If she has endometriosis, she needs an OB/GYN.  Sometimes I take a 'stab' at the source of the pain, but those stabs are usually out of my area of expertise.  Please make use of the other specialists on the board, and 'in real life', as the chronic pain docs  are more focused on treating the pain, rather than going after the underlying problem.

GT59, the symptoms you describe could be consistent with a sick gallbladder-- for example the sharp pains can be associated with passing a gallstone, and the lump under the right ribcage is just where the gallbladder sits.  A sick gallbladder will become firm and enlarged, and will cause a wide range of GI symptoms;  A colonoscopy would be negative.  Call the radiologist at your hospital and ask if he can see your gallbladder on your ct scan, and if he can, ask if there are gallstones-- not necessary to a sick gallbladder, but the presence of stones would suggest that as the source of your pain.

[Jaybay]

Have you ever had any abdominal surgery or genecological issues?  Is it worse after eating or during your period?  Does anything like over the counter meds help the pain?  I'm not the doctor but have had lots of abdominal issues.  Just trying to figure out if it's something for a gastroenterologist or a gynecologist or someone else.  

Pain is generally considered chronic when it's of at least 6 months duration, so I don't know how much Dr. J. will be able to help you, particularly without a firm diagnosis.  No doubt he'll have some ideas for you to look into though.  :-)